Wow! This has been the huge question in #IACI mitochondrial dysfunction. If lactate is accumulating why won't the mitochondria just use that for fuel? Well... Guess what else is dysfunctional? Carnitine metabolism
Our body (cells) have fuel preference, e.g., burning fat vs. carbohydrates, which depends on the environment and nutritional states. How do cells decide which fuels to use?  Our new study found that carnitine biosynthesis is crucial for fuel switching science.org/doi/10.1126/scie…

Jan 9, 2026 · 11:24 PM UTC

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Replying to @ImmunoFever
Wow!! 1960's biochemistry 🤦‍♂️
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It all comes back eventually
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Replying to @ImmunoFever
Except that lactate can increase against normal carnitine synthesis depending on which complex failure(s) occur.
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Replying to @ImmunoFever
Defects in carnitine metabolism, fatty acid metabolism, oxygen uptake, plus lactic acid accumulation.... I'm starting to wonder if anything about our metabolism is working correctly.
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Replying to @ImmunoFever
Mitochondrial dysfunction would have the same impact - an inability to use lactate as a fuel
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Replying to @ImmunoFever
How does that work in endometriosis + me/cfs? Carnitine can worsen endometriosis lesions pain. Why is that?
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Replying to @ImmunoFever
@KatBoniface …knew you should see this
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